Fibroblast-Activation Protein PET and Histopathology in a Single-Center Database of 324 Patients and 21 Tumor Entities

被引：38

作者：

Hirmas, Nader ^{[1
,2
]}

Hamacher, Rainer ^{[3
,4
]}

Sraieb, Miriam ^{[1
,2
]}

Ingenwerth, Marc ^{[5
]}

Kessler, Lukas ^{[1
,2
]}

Pabst, Kim M. ^{[1
,2
]}

Barbato, Francesco ^{[1
,2
]}

Lueckerath, Katharina ^{[1
,2
]}

Kasper, Stefan ^{[3
,4
]}

Nader, Michael ^{[1
,2
]}

Schildhaus, Hans-Ulrich ^{[5
,6
]}

Kesch, Claudia ^{[7
]}

von Tresckow, Bastian ^{[4
,8
]}

Hanoun, Christine ^{[4
,8
]}

Hautzel, Hubertus ^{[1
,2
]}

Aigner, Clemens ^{[4
,9
]}

Glas, Martin ^{[4
,10
]}

Stuschke, Martin ^{[4
,11
]}

Kummel, Sherko ^{[12
,13
]}

Harter, Philipp ^{[14
]}

Lugnier, Celine ^{[15
]}

Uhl, Waldemar ^{[16
]}

Niedergethmann, Marco ^{[17
]}

Hadaschik, Boris ^{[7
]}

Grunwald, Viktor ^{[7
]}

Siveke, Jens T. ^{[18
,19
,20
]}

Herrmann, Ken ^{[1
,2
]}

Fendler, Wolfgang P. ^{[1
,2
]}

机构：

[1] Univ Duisburg Essen, Dept Nucl Med, Essen, Germany

[2] Univ Hosp Essen, German Canc Consortium DKTK, Essen, Germany

[3] Univ Duisburg Essen, West German Canc Ctr, Dept Med Oncol, Essen, Germany

[4] DKTK Univ Hosp Essen, Essen, Germany

[5] Univ Hosp Essen, Inst Pathol, Essen, Germany

[6] Targos Mol Pathol Inc, Kassel, Germany

[7] Univ Duisburg Essen, Dept Urol, Essen, Germany

[8] Univ Duisburg Essen, Dept Hematol & Stem Cell Transplantat, Essen, Germany

[9] Univ Duisburg Essen, Dept Thorac Surg & Thorac Endoscopy, Essen, Germany

[10] Univ Duisburg Essen, Div Clin Neurooncol, Dept Neurol, Essen, Germany

[11] Univ Duisburg Essen, Dept Radiat Therapy, Essen, Germany

[12] Kliniken Essen Mitte, Breast Unit, Essen, Germany

[13] Charite Univ Med Berlin, Dept Gynecol Breast Ctr, Berlin, Germany

[14] Evang Kliniken Essen Mitte, Dept Gynecol & Gynecol Oncol, Essen, Germany

[15] Ruhr Univ Bochum, Dept Hematol & Oncol Palliat Care, Bochum, Germany

[16] Ruhr Univ Bochum, Dept Gen & Visceral Surg, Bochum, Germany

[17] Alfried Krupp Hosp, Clin Gen & Visceral Surg, Essen, Germany

[18] Univ Hosp Essen, Bridge Inst Expt Tumor Therapy, West German Canc Ctr, Essen, Germany

[19] DKTK Partner Site Essen, Div Solid Tumor Translat Oncol, Heidelberg, Germany

[20] German Canc Res Ctr, Heidelberg, Germany

来源：

JOURNAL OF NUCLEAR MEDICINE | 2023年 / 64卷 / 05期

关键词：

FAPI; PET; oncology; staging; theranostic; CANCER; CARCINOMA;

D O I：

10.2967/jnumed.122.264689

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

We present an overview of our prospective fibroblast-activation pro-tein inhibitor (FAPI) registry study across a 3-y period, with head-to -head comparison of tumor uptake in 68Ga-FAPI and 18F-FDG PET, as well as FAP immunohistochemistry. Methods: This is an interim anal-ysis of the ongoing 68Ga-FAPI PET prospective observational trial at our department. Patients who underwent clinical imaging with 68Ga-FAPI PET between October 2018 and October 2021 were included. Tracer uptake was quantified by SUVmax for tumor lesions and by SUVmean for normal organs. PET tumor volume (40% isocontour) and tumor-to-background ratios were calculated. Correlation between SUVmax and FAP staining in tissue samples was analyzed. Results: In total, 324 patients with 21 different tumor entities underwent 68Ga-FAPI imaging; 237 patients additionally received 18F-FDG PET. The most common tumor entities were sarcoma (131/324, 40%), pancre-atic cancer (67/324, 21%), and primary tumors of the brain (22/324, 7%). The mean primary tumor SUVmax was significantly higher for 68Ga-FAPI than 18F-FDG among pancreatic cancer (13.2 vs. 6.1, P < 0.001) and sarcoma (14.3 vs. 9.4, P < 0.001), and the same was true for mean SUVmax in metastatic lesions of pancreatic cancer (9.4 vs. 5.5, P < 0.001). Mean primary tumor maximum tumor-to-background ratio was significantly higher for 68Ga-FAPI than 18F-FDG across sev-eral tumor entities, most prominently pancreatic cancer (14.7 vs. 3.0, P < 0.001) and sarcoma (17.3 vs. 4.7, P < 0.001). Compared with 18F-FDG, 68Ga-FAPI showed superior detection for locoregional dis-ease in sarcoma (52 vs. 48 total regions detected) and for distant met-astatic disease in both sarcoma (137 vs. 131) and pancreatic cancer (65 vs. 57), respectively. Among 61 histopathology samples, there was a positive correlation between 68Ga-FAPI SUVmax and overall FAP immunohistochemistry score (r = 0.352, P = 0.005). Conclusion: 68Ga-FAPI demonstrates higher absolute uptake in pancreatic cancer and sarcoma, as well as higher tumor-to-background uptake along with improved tumor detection for pancreatic cancer, sarcoma, and other tumor entities when compared with 18F-FDG. 68Ga-FAPI is a new tool for tumor staging with theranostic potential.

引用

页码：711 / 716

页数：6

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